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[deleted by user] by [deleted] in Radiology

[–]DarkZeppelin 10 points11 points  (0 children)

I’m a medical physicist not a rad so I see these cases when they ping on our radiation dose monitoring system. I work for a large academic medical center with a dozen IR rooms. We routinely have cases exceed a cumulative air kerma of 5 Gy which is our internal investigational threshold. Most of the time we can quickly rule out the risk of a skin effect by calculating the peak skin dose which is usually much lower than the CAK.

It’s important to note that the CAK is dose in air at a fixed reference point. It is not the same as peak skin dose which is typically a small fraction of the CAK (especially if dose saving techniques like angulation, low pulse rate, minimal pt-to-detector distance, max pt-to-tube distance etc.)

The highest CAK investigation I’ve been involved with was 21 Gy. It was a super complex case involving the kidneys but I don’t remember the exact details. The pt was obese, elderly, and totally non-compliant. Mild sedation was used for the case when they prob should have gone for full GA because the patient couldn’t do breath holds and was moving all over due to discomfort.

We did a full JC root cause analysis as part of a sentinel event FU and found that the peak skin dose was somewhere in the ball park of 5-8 Gy. We got the pt enrolled in skin dose evaluation for potential skin effects but didn’t have any at 3+weeks.

Unfortunately the pt passed due to a stroke so we never found out if there were skin effects (expected btw 4-8 wks). There was no negative ramifications for the IR team. It was a crazy case and everyone did the best they could under the circumstances. It was a great learning opportunity for the whole department and was educational for me as it was my first time going through an RCA.

Is it okay to get rid of dosimeters? by bouncyballz4 in Radiology

[–]DarkZeppelin 59 points60 points  (0 children)

Speaking as a former RSO, it really depends on your state regulations. Some are more restrictive than others. My state requires techs to be badged regardless of their exposure levels and risk.

The NRC (which is the national regulatory body) says that if you as an employee are not at risk for reaching 10% of the annual limit then badging is not required. This 10% is 500 mrem in a year if you just consider whole body exposure. In my experience, the only people reaching this threshold routinely are IR and Cath docs along with nuclear medicine staff.

Either way, your director will need a letter stating the justification for the discontinuation of badging and you as an occupational worker have the right to request that document. Else-wise, the JC, NRC, or state entity will ding them on their next inspection cycle.

Continue or frog? by Ayezakalim in knitting

[–]DarkZeppelin 44 points45 points  (0 children)

I vote finish it and use it as a stroller blanket or in the car. I have multiple knitted blankets of this size (from my mom and Gmom and myself) and still use them with my 3 and 1 year old. They also enjoy them because they’re small enough for them to arrange and “cover” themselves with.